ERIC ED343704: Home-Based Family-Centered Services: A Response to the Child Welfare Crisis. Occasional Paper No. 1.

21 Pages·1991·0.78 MB·English

by  ERIC

DOCUMENT RESUME
ED 343 704
PS 020 431
TITLE
Home-Ba.led Family-Centered Services: A Response to
the ChilC Welfare CrisiS. Occasional Paper No. 1.
INSTITUTION
Indiana Youth inst., Indianapolis.
PUB DATE
91
NOTE
24p.
PUB TYPE
Viewpoints (Opinion/Position Papers, Essays, etc.)
(120) -- Reports - Descriptive (141)
EDRS PRICE
MF01/PC01 Plus Postage.
DESCRIPTORS
*Child Welfare; Day r.lare; *Family Problems; *Family
Programs; *Home Programs; *Program Costs; *Sc:ial
Services
IDENTIFIERS
*Indiana
ABSTRACT
This paper proposes the use of home-based,
family-centered services that are designed to
encourage the healthy
development of children in their families. Such services
would
constitute part of a comprehensive approach to the child
welfare
problem in Indiana. The goals of family-centered
services are to:
(1)
preserve the integrity of the family; (2) link children and familtes
with community agencies; and (3) strengthen families, coping
skills.
The impact, in human terms, of lack of family services
is illustrated
by a case scenario. The problems encountered by
the family in this
scenario could have been preventint by a family-centered
service plan
that included income assistance, child care, transportation,
parent
education, and social support. In financial
terms, home-based,
family-centered services would cost less than foster
care and
institutional placement. Several Indiana communities have
recently
implemented home-based, family-centered
programs. Two such programs
are Families United, which provides services to families
in six rural
counties; and the Family Life and Education Program,
an urban
home-based service model serving families in eight
central Indiana
counties. Appendixes include flyers describing
the child welfare cost
crisis and the Indiana child and family support
campaign.
(BC)
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V=.11IT11111=11..
Home-Based Family-Centered
Services: A Response to
the Child Welfare Crisis
1991
Occasional Paper No. 1
-PERMISSION TO REPRODUCE THIS
The
MATERIAL HAS BEEN GRANTED BY
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\r\
\ox\
Youth Institute
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*Copyright 1991© By the Indiana Youth Institute. The Indiana Youth Institute Occasional Paper is
published In the public interest by the Indiana Youth Institute, a tax-exempt non-profit organization.
Readers are encouraged to copy and share its contents; we request that you credit the Indiana Youth
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BEST COPY AVAILABLE
Home-Based Family-Centered Services:
A Response to the Child Welfare Crisis
Introduction
Conferees at the Indiana Youth Institute's 1990 annual conference,
"Growing Up In Indiana: A New Vision," reviewed and revised
a
working draft of 10 "blueprints" for the healthy development of all
Indiana's children (see back page). One basic premise is
common to
these blueprints:
Every chi1 C4 in Indiana--regardless of
race, gender, ethnicity,
handicapping condition, geographical location
or economic
status--deserves an equal opportunity to
grow up in a safe,
healthy, and nurturing environment.
Many advocates fear that the erosion of Indiana's child protective service
system is seriously compromising this basic premise. In
response to this
concern, the Indiana Youth Institute issued a special report entitled "A
Crisis in Child Welfare: The High Cost of Negjecting
a System," in
January 1990, and reissued the report, updated, in January 1991
(Appendix A). This report brought attention to
a number of troubling
indicators that suggest the need for change in the
way Indiana addresses
child protective services. One indicator of the child welfare crisis
is the
increasing number of Indiana's children removed from their
homes and
placed in substitute care. Figure 1 shows that there has
been a 47 percent
increase in the number of Indiana children in substitute
care in the last
five years.1 This is even more alarming when
one considers that
population estimates for the state of Indiana from 1985
to 1990 show a
3.7 percent decline in 0-19 years old.2
This paper proposes the use of hcme-based, family-centered
services as
one option for encouraging the healthy development of children within
their fami:les as part of a comprehensive approach
to the child welfare
problem. The Indiana Youth Institute has joined forces with
the Indiana
Child and Family Support Campaign to raise public
awareness of the
needs of children and families who live in poverty.
3
Indiana Youth hutitute
Occasional Paper No. 1
3
The goals of HBFC services dre threefold:
to preserve the integrity of the family and prevent unnecessary out-
of-home placement;
to link the child and family with appropriate community agencies
and individuals in order to create an ongoing community support
system; and
to strengthen the family's coping skills and capacity to function
effectively in the community.3
The Impact of the Crisis in Human Terms
A recent report issued by the National Center for Children in Poverty
noted that among poor families, situational factors may be responsible for
as much is 90 percent of child maltreatment. Severe stress, lack of
social supports, and dangerous housing in disrupted neighborhoods are
some of these situational factors. The same report cited a 1986 national
survey that found maltreatment of children to be "about seven times as
great among families with an annual income below $15,000 as among
families with an annual income over $15,000. Rates of abuse were
almost five times as high among low-income children as among others,
and rates of neglect were nine times as high."
The following real case scenario demonstrates what frequently happens to
vulnerable families in the absence of a child protective service safety net.
Names have been changed and circumstances have been modified to
safeguard confidentiality.
Sarah grew up in poverty. Her first child, Josh, was born when
she was 15; her second, Amy, when she was 16. When Sarah
was 18 years old, Josh and Amy were removed from her home
and never returned to live with her after the spring of 1980.
Sarah's father, an unskilled worker with a seventh-grade
education, was frequently unemployed. Sarah was the oldest of
four girls.
Her mother suffered poor health, with the result that
Sarah had responsibility thrust upon her at an early age. One of
the few "nurturing" relationships that Sarah experienced in her
life was with Sam, the pizza delivery boy. Sam frequently
provided Sarah and her sisters with unclaimed food from his
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Occasional Paper No. 1
Indiana Youth Institute
4
delivery route. Her affection for Sam
grew. When she became
pregnant by Sam, she quit high school, and her parents threw her
aut.
Sam and Sarah could not afford prenatal
care. Their son Josh
was born two months prematurely and was subject to chronic
ear
infections. When Amy was conceived, Sarah and Sam's
relationship deteriorated, and Sam left the state.
Sarah applied for Food Stamps and Aid For Dependent
Children.
She had to make difficult choices
among food, housing, clothing,
and medical expenses for her children. (By 1989,
Indiana's
maximum AFDC benefit had declined
to about 33 percent of the
Federal Poverty Level; Food Stamps could have raised
income
for a family of three to about 62 percent of the
Poverty Level.)
At the grocery in the winter of 1980, three-year-old
Josh pulled
a jar out of a display and a pyramid of grape jam toppled
over
on him, breaking half the items in the display. The storekeepr
insisted that Sarah pay for the damage, which
amounted to $27.
This figure represented a sizeable proportion of
her monthly
income. Sarah paid for the damage at the
expense of Amy's
diaper budget. After Sarah rationed Amy's
disposable diapers,
Amy developed a diaper rash, which became
infected. Amy was
unable to sleep and developed
a fever. Concerned, Sarah took
both children to the public health clinic.
The nurse who examined Amy
was legally compelled to report
the child's condition to the family's welfare
caseworker. Josh
was rambunctious in the doctor's office. Tired, overwhelmed,
and angry with Josh, Sarah lost control. She
slapped Josh in the
face and blamed him for her
current situation.
An inexperienced, newly-hired caseworker
was assigned to
investigate the referral from the
nurse. The rural county welfare
departmerA did not have sufficient staff
to keep up with the high
volume of referrals. Unable to monitor Sarah's
situation, the
caseworker recommended temporaly foster
care. The court
removed both children from the home.
(The Child Prvtective Service system fails:
the caseworker will
process 100 cases per year. In 1980, a beginning caseworker
would have earned
a salary of $12,800 per year = $128 initial
investment/
5
Indiana Youth laminate
Occasional Paper No. 1
Sarah slumped into a depression and began abusing alcohol. She
lived on the outskirts of a small town and had no transportation.
Her children had been placed in a foster home 30 miles away,
which made regular visitation difficult. The new caseworker
could provide transportation for monthly visits only.
While Amy responded well to her foster family, Josh did not.
He was angry and experienced night terrors, waking up nightly
crying for his mother. The foster parents' frustration was
exacerbated by having to work with three different caseworkers
in a twelve-month period. The foster father was missing so
much sleep that his job was in jeopardy. Reluctantly, they
decided to give up. The welfare department had to find another
placement for Josh.
The welfare department was unable to provide Sarah with the
support services she needed while her children were out of the
home. Sarah's case was passed on to a succession of workers,
each with a higher caseload than the last. Sarah's situation did
not improve. The judge, advised by yet another caseworker, saw
reunification of this family as too risky. In 1985, five years
after the children had been removed, the court terminated
Sarah's parental rights.
(Foster care for Amy, 16 yews a $4000+per year = $64,000;
foster care for Josh, 10 yews at $4000+per year = $40,000)
Years passed. Amy adjusted to her foster family. However,
Josh went through nine foster home placements, seldom
remaining more than one year in any home. He never managed
to bond with any adult. He felt mistrustful of adults and
frequently lashed out at authority.
Josh was picked up for shoplifting at age 11. When he was 12,
a teacher discovered that he had brought a knife to school, and
he was suspended. When Josh was 13, the court judged him to
be delinquent. He was committed to the Department of
Correction and sent to Boys' School. At age 14, Josh was
placed in a residential treatment center, where he stayed for two
years.
(Boys' Scho o 1 for Josh, 6 months at $25 per day = $4,500;
residendal ewe for Josh, 2 yews 1730 days] a t $80 per day =
$58,400)
By this time, Josh had acquired a reputation for victimizing
younger, weaker children. Twelve caseworkers had been
Occasional l'apec No. 1
Indiana Youth Institute
6
assigned to Josh since he was three
years old. His latest
caseworker reported that he met the profile of
many children
who pass through the child welfare system. "Prognosis for
the
future is poor. If his behavior doesn't improve, Josh will likely
spend as much time incarcerated in the adult correctional
system
as he will on the streets."
64ctual cost s for substitute
eare for the children = $166,900;
printed cost of ohs& incarceration for Josh, 10
yews a
$2.5,000 per yew = $250,000; total potential
cost for substitute
care = $416,900)
This family's downward spiral did
not have to happen. Had home-based,
family-centered (HBFC) supports been available
at the critical time of
need, this family might have stayed together and
developed in a healthy
manner. A HBFC service plan for Sarah and her children would have
been responsive to their needs. The plan
could have included the
following ingredients:
income assistance
- providing emergency funds so that
Sarah could purchase
necessary provisions for her children,
such as food, diapers, and medicine; teaching
budgeting
skills to prevent temporary shortages in
the future;
child care
- locating affordable child care to enable Sarah
to return to school to complete her high school education;
transportation
- providing transportation either directly or
through a local vendor, to enable Sarah
to attend high
school, meet the health
care needs of her children, and
attend support
groups;
parent education
- assisting Sarah, in her home, to improve
and use effective parenting skills, such
as child
management, discipline, and nurturing; and
social supports
- reducing Sarah's isolation by involving
her in a group of single-parent mothers
to develop a system
of peer supports, improve her self-esteem,
and develop her
capacity for self-ilelp.
Providers of HBFC services work with
the family in the home and
community to assist with day-to-day
child care routines. A healthy
routine often breaks down when
a family lives in poverty or is under
stress. HBFC case managers assist by providing
supports, including
7
Indiana Youth !Minn Occasional Pacer No. 1
7
wake-ups, assistance at mealtime, shopping, budgeting, finding child care,
and providing instruction on the use of community resources.
HBFC case managers or family advocates understand that each family's
situation is different. They make a thorough assessment of each family's
strengths and wealaiesses to see that its individual needs are carefully
addressed. This assessment determines the case plan.
A family advocate will frequently involve the family or family members
in su?port groups with other families who are experiencing similar
difficulties. Involvement in a support group is especially effective with
single parents who are struggling to overcome feelings of loneliness. The
which increases
group enables them to develop a peer-support system,
their self-esteem. Of equal importance is the sense of empowerment that
HBFC strives to instill in parents. The support that parents receive
enables them to remain in charge of their children. Further, parents'
active participation in decision-making discourage dependency by
focusing on problem solving, skill building, and use of community
6
resources.
A trained family advocate, salaried at $25,000 per year, could have
sustained a six-month involvement with Sarah and her family for no more
than $2,500 (assuming that the family advocate provided intensive casr
It is conceivable that the
management to ten to fifteen families per year).
potential long-term expenditure of over $400,000 could have been saved
with such a modest initial investment. Beyond the dollar cost of
substitute care, is the suffering of a young mother and the wasted
potential of her son. Such human costs cannot be calculated.
HBFC employees are typically well-trained, energetic and dedicated
caseworkers. They carry small caseloads--as few as three families and
seldom exceeding twelve families--enabling them to spend three to ten
hours per week with each family. The caseworker's attention and
concern for the family's welfare builds trust and encourages the family's
confidence in other community services that can reduce the family's
feelings of isolation. HBFC supports are time-limited, usually lasting a
few weeks, and seldom more than nine months.
8
Occasional Paper No. 1
Indiana Youth Institute
8
The impact of the Crisis in Financial
Terms
In addition to the feelings of loss and
inadequacy that the child and
family members experience when separated, the
financial costs for
substitute care are significant. Nationally, billions
of dollars are
expended for out-of-home
care for children.7 Yet data collected from
HBFC programs consistently show that from
70 to 90 percent of families
with children at risk of out-of-home
placement can be helped to remain
together.'
In Indiana, individual
county budgets are burdened by the escalating
numbers and costs for the substitute
care of abused, neglected, and
delinquent youth. Over 70 percent of the
investment in child welfare
(Figure 2) is expended to support various
forms of substitute care,
including institutional, foster, and psychiatric
hospital care.9
Figure 2. Millions of Dollars Supporting Child Welfare
182
1980
1981
1983
1934
1995
194
1915
1997
193
19138
The burden has increased enough
to receive legislative attention.
In
1989, the Indiana General Assembly passed
a law enabling counties to
appeal to the State Board of Tax Commissioners
for excess tax levies to
accommodate these increasing
costs. Counties must acquire loans to
meet budgetary shortfalls for substitute
In 1989 the State Welfare
care.
Board gave approval for
ten counties to either borrow money
or issue a
bond to support the costs of substitute
care (Table 1)."
9
Indiana Youth Institute
Oceational Paper No. 1
ft
: " s
,..., ,.
sv, v ktr4z.
, ::., N)
N.45 1,77Fk.
4*
s
%
is.
N't4Ye
s 5 \,.. W '. qkke,
1
1
.k
..
y>
ty.5s.v..541
%
g'
cdt'
,--...*
..
Ab. ,
-.....),..........
...
...4
.4
4
.:.:.
.
Amount Borrowed
Indians County
.
$60,000
Davies
353,800
Howard
500,000
Johnson
211,849
1 LaGrange
Lake
1,877,$ 00
3,090,000
Marion
66,000
Martin
282,000
Monroe
147,000
Pulaski
450,000
Tippecanoe
TOTAL
S7,038,149
In 1990, 13 counties approached the State Welfare Board for approval to
borrow money (Table 2).11
_
'
, *,...p :::,s
io.
a
.:::K:-.
%5
..s
.....::.Ikx,..);.,,,.....4
:.:
dftotaI
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.x.
.,
-:4
MI1P,::
'
,
-
s
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11
,
.
,
.
.
''''
%
.N.
`.4.%
Indiana County Amount Borrowed
Cass
277,466
2
56,600
Carroll
9,278
5
Fu I ton
Henry
77,072
5,892,000
La ke
5,587,000
Marion
7,808
7
Mart in
136,820
Miami
402,000
Monroe
Newton
165,0r i
,741,987
St. Joseph
1
87,420
Steuhen
949,507
Tippecanoe
TOTAL
15,709,958
Occasional Paper No.
Indiana Youth Institute